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General NPI Number Information
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NPI Number | 1578725149
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Entity Type | Organization
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Legal Business Name | COMMUNITY OPTIONS, INC.
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 444 SCOTT ST
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City | GREEN LAKE
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State | WI
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Zip | 54941-9423
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Country | US
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Telephone | 920-294-6099
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Fax | 920-294-3060
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Provider Business Mailing Address
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Address Line | PO BOX 189 444 SCOTT ST.
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City | GREEN LAKE
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State | WI
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Zip | 54941-0189
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Country | US
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Telephone | 920-294-6099
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Fax | 920-294-3060
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. MARIAN L SOMMERFELDT
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Credential |
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Telephone | 920-294-6099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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